Tuesday, December 12, 2006

Q&A Peter Kramer

Originally appeared in the Boston Globe,

By Harvey Blume

When I phoned Peter Kramer recently to talk about his new
book, "Freud: Inventor of the Modern Mind," he said the volume
represented his "most negative" encounter yet in a "lifelong
series of encounters" with the work of Sigmund Freud. Given Kramer's knack
for summing up and helping to shape the zeitgeist -- as demonstrated by his
1993 bestseller "Listening To Prozac" -- a negative report from him
is not good news for 21st-century Freudianism.

To be sure, "Listening To Prozac" had already
nudged Freud toward the sidelines. Kramer argued in that book that
antidepressants like Prozac promoted notions of the mind, the brain, mental
health, and personal identity that conflicted with the psychoanalytic model.
Kramer maintained that "modern psychopharmacology" was poised to
become, "like Freud in his day, a whole climate of opinion under which we
conduct our different lives."

But the Kramer of "Freud" is no longer content
just to wait for psychiatric climate change; he demands it. That's not because
he's more enthusiastic about psychopharmacology. On the contrary, in
"Against Depression" (2005), he's forthright about the fact that
Prozac and related drugs have turned out to have only limited use in the
treatment of clinical depression.

No, Kramer's impatience with Freud stems from his having
steeped himself in tales of psychoanalysis told by people who were actually
analyzed by the master. These make up a sort of samizdat literature of
psychoanalysis, widely at variance with the self-congratulatory accounts penned
by Freud himself. Kramer, who is a practicing psychiatrist and a professor of
psychiatry at Brown University, has written that he had once "loved and
admired Freud." But, he told me, when the new literature let him peek over
"Freud's shoulders into how he really conducted his cases and drew his
conclusions, it was disappointing."

Kramer attributes some of Freud's success to his having been
"an inspired storyteller," adept, for example, at blaming patients
when therapeutic disaster struck. Kramer is a skilled storyteller, too. His
slim, absorbing book makes a strong case that Freud was crafty, despotic, and "focused
single-mindedly on his own interests."

IDEAS: You think Freud will ultimately be remembered more as
a great writer than as a scientist, don't you?

KRAMER: I was just at a conference with my humanities
colleagues -- philosophers, literary critics, and so on. Freud had been so rich
for them because of the sense that science had placed its imprimatur on him. I
was the party pooper, saying science has withdrawn its approval.

IDEAS: One of your complaints is that Freud wasn't really
very original.

KRAMER: True, but a lot of the things Freud championed that
were not original have remained valuable, like psychotherapy. You can't say
Freud's particular psychotherapy stems from the most legitimate view of the
human mind and is most effective. But there is something about spending time
with a concerned person and engaging in some thoughtful project about the self
that seems valuable to people. Beyond that, we have difficulty specifying what
goes on.

IDEAS: Freud's been attacked from many sides before. What's
novel about your book, it seems, is the focus on the difference between what
Freud said about therapy and what many of his patients said.

KRAMER: I think that is new. I don't think anyone before has
taken a linear biographical approach and pulled in all this critical history.
And what does Freud look like over the course of an intellectual life? He does
look bad.

Let me admit that there may be a personal aspect to this. I
am an atheist, of European Jewish origins. And it seems to me that if you are
going to be an avatar of secular European Jewish thought, as Freud was, you
should have your hands on the table every now and then.

IDEAS: "Hands on the table" is a curious turn of
phrase. Let me take up one implication and ask why Freud is so interested in
masturbation.

KRAMER: Early on he needed some dynamic that connected mind
and body. His answer had to do with the notion that if you didn't release sexual
energy the right way, you had these mental illnesses. He never got very far
from that. Masturbation and coitus interruptus keep coming up as harmful to
brain and mind. And we know from his letters he seems to have had remarkably
little actual sex with another person.

IDEAS: Again, what are you implying?

KRAMER: Look, one of the things I struggle with in this book
is: How important was he? If he's not like Darwin or Copernicus, if he was
often wrong and wrong in ways that were apparent at the time, not just in
retrospect, how is it he captured the imagination of an era? I think his focus
on personal sexual history -- masturbation, fantasy, maybe early escapades or
traumas -- was very interesting to lots of men and to lots of doctors. People
in the Viennese Psychoanalytic Society, early on, were discussing their own
sexual history. It was liberating to do that, though not especially rebellious.
Here, again, psychoanalysis was about giving a scientific stamp to a central
interest of journalism, fiction, and theater.

IDEAS: So Freud crystallizes the zeitgeist?

KRAMER: To have your finger on the pulse of the zeitgeist is
a form of genius. But being wrong is a problem. It's clear to me that if Freud
had never lived, medical science would be pretty close to where it is now.

IDEAS: Still, much as you discredit Freud, you seem wistful
about him. You seem to miss him.

KRAMER: We no longer have a comprehensive theory of mind.
The neurological take, mostly, is that mind is effectively an illusion. But in
our everyday life, we believe we have mind and self and continuous personality.
Freud thought he had a system for saying how those are arrayed and develop.
We've lost that.

Intuitively, we are Cartesians. We think there's something
that needs to be explained about the connection between mind and body. Freud
was more optimistic than we are about getting it right. It isn't that we now
have some theory that's better than Freud's. And we're not on the verge of one.
There's a sense of loss.

But what are we to do? That is the problem with
psychotherapy. I can sit across from another person -- I'm going to do it this
afternoon a few times -- but what is the basis for my responses when someone
behaves or talks in a certain way? There are many kinds of psychotherapy. Why is
one better than another? We're agnostic now. It's not that Freud has been
superseded by a better theory of mind. We do without.

IDEAS: You write fiction, too. Your novel, "Spectacular
Happiness," a portrayal of a Cape Cod ecoterrorist who likes to swim and
to read, had the bad luck to come out around 9/11.

KRAMER: [laughing] A month before 9/11. I comfort myself by
thinking if it had come out a month later it wouldn't have been better.

There's a strain in my work that allows for lots of things
to be psychotherapy. In "Spectacular Happiness," a therapist thinks a
good explosion or two might help bring his patients back into accord with
themselves. But does liberating the self justify everything?